Outcomes after micro-lumbar discectomy (MLD), done as described in this blog, were surveyed by questionnaire. Patient were asked to check one of four options for their present symptoms: Excellent – no pain and able to resume normal activities, Good – some pain but not requiring medication and most activities resumed without limitations, Fair – pain less but continued to need pain medication and/or unable to resume previous work or activities, Poor – not significantly improved. No patient was made permanently worse. I considered a satisfactory result to be either Excellent or Good – 92% of cases.
Patients operated on and found to not have an HNP or only degenerated discs had 65% satisfactory results. That was somewhat surprising, but a 65% improvement rate can be obtained with non-surgical management. So in retrospect surgery was not indicated for those patients. They were operated on because of false-positive imaging studies in most cases.
So it isn’t possible to guarantee an operation will find a herniated disc in all cases, but with modern imaging and careful examination of patients, the probability of finding a HNP at surgery can be raised to above the level where surgery gives the best chance for relief.